Archived: Highcliffe House Nursing Home

Updated 15 March 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 14 January 2019 and was unannounced. The inspection team consisted of two inspectors, a specialist professional advisor in nursing care for older people and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. On this occasion our expert had experience of caring for a family member who was living with dementia in a care home.

Before the inspection we reviewed information available to us about this service. The registered provider had completed a Provider Information Return (PIR). This is a document that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We looked at the information provided in the PIR and used this to help inform our inspection. We also spoke with stakeholders, including the local authority safeguarding team.

We reviewed the provider’s updated action plan as well as previous inspection reports, the details of any safeguarding events and statutory notifications sent by the provider. A notification is information about important events which the provider is required to tell us about by law, like a death or a serious injury. We used this information to plan what areas we were going to focus on during our inspection.

We spoke with eight people who could express their views of the service they received. We also observed care to help us understand the experiences of those people who were unable to communicate effectively with us.

We also spoke with three relatives of people living at the service, five members of staff, a nurse and the clinical lead. We reviewed seven people's care plans. We also looked at a sample of the service's quality assurance systems, staff training records, staff duty rotas and complaints records.

Updated 15 March 2019

We undertook an unannounced focused inspection of Highcliffe House Nursing Home on 14 January 2019. This inspection was done to check that improvements to meet legal requirements planned by the provider had been made after our comprehensive inspection on 25 April 2018. The team inspected the service against two of the five questions we ask about services: is the service well led and is the service safe? This is because the service was not meeting some legal requirements.

No risks, concerns or significant improvement were identified in the remaining key questions through our ongoing monitoring or during our inspection activity so we did not inspect them. The ratings from the previous comprehensive inspection for these key questions were included in calculating the overall rating in this inspection.

The inspection took place on 14 January 2019 and was unannounced. During our last inspection on 25 April 2018 we found breaches to Regulations 17 and 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. During this inspection we found that improvements had been made. There was still improvement needed, which was underway and the service was no longer in breach of regulation.

Following our last inspection in April 2018, the overall rating for this service was 'Inadequate' and the service was put in 'special measures'. The service was kept under review and was inspected again within six months. Because, during this inspection we found the service had made sufficient improvement to be rated requires improvement, this service is no longer in special measures.

Highcliffe House Nursing Home is a 30-bedded residential and nursing care service providing care, treatment and support, including end of life and care and support for people living with dementia. On the day of our inspection there were 19 people living at the service.

At the time of our previous inspection in April 2018, the registered manager was also a director of the registered provider. Soon after that inspection the registered manager stepped down and a new manager had been appointed who had started the process of becoming registered. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Highcliffe House a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service accommodates people in one adapted building close to the sea in Felixstowe.

During our last inspection in April 2018, we found that not all internal doors that had signage to say, 'keep locked shut' for people's safety were kept locked. During this inspection we found that these doors were locked, keeping materials that could be harmful to people safe and steps had also been taken to ensure that access to the cellar was monitored when staff were in the kitchen to ensure people were safe from falling down the stairs, but this gate needs to be kept locked at all times.

Improvements had been made in the quality of people’s care plans and the way that risks were identified and measures put in place to help protect people from harm. But the standard was not consistent throughout people’s care plans and we found that a piece of equipment mentioned in a risk assessment that was essential for the person’s safety was not in working order. This was rectified immediately.

People where protected from bullying, harassment, avoidable harm and abuse by staff that were trained to recognise abusive situations and knew how to report any incidents they witness or suspected. Improvements had been made since our previous inspection and appropriate safeguarding referrals had been made.

People were protected by staff that had been safely recruited.

Medicines were managed in a way that ensured that people received them safely and at the right time. There were also appropriate infection control practices in place to help protect people, visitors and staff from infectious disease.

Staffing levels were sufficient to keep people safe on the day of our inspection. We saw evidence that lessons were learnt and improvements made when things went wrong.

The way the service was managed had improved since our last inspection and the provider and manager had made a positive move towards improving the service. There were systems in place to monitor the quality of service the providers offered people, however there were still some inconsistency in records and in identifying the concerns including those we identified during this inspection.

Improvements had been made in the culture of the service. Staff told us that things had improved and the service was a better, happier place to work in. People and staff told us the manager was open, supportive and had a good, caring attitude in the way they believed people and staff should be supported.

The service had worked in partnership with other agencies whilst working to make improvements to the quality of care offered to the people they support.